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Service Recipient Application
Please provide your contact information below:
Your Primary Need(s): Home maintenance / repairs Yard maintenance Meal preparation / delivery Grocery shopping / errands Car repair / maintenance Home cleaning Home-bound care (household tasks, haircut, manicure, etc. - please specify below) Pet care while incapacitated Job search (resume preparation, interviewing skills) Transportation needs (i.e. church, doctor, etc. - please specify below) Other (please specify below)
Additional comments:
Please describe your reason(s) for needing assistance ( i.e. disability, sickness, etc.):
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